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Reconstruction of Complex Scalp Defects in Different Locations: Suggestions for Puzzle
Soysal Bas1, Cagatay Oner2, Hikmet Ihsan Eren1
1Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastanesi Tip Bulteni
|October 29, 2021
Summary
Free tissue transfers are recommended for complex scalp defects, offering superior outcomes compared to local flaps. Careful selection of reconstruction methods is crucial for successful patient recovery and aesthetic results.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Scalp defects arise from trauma, radiation, or oncologic resections, impacting both protection and aesthetics.
- Traditional reconstructive methods are insufficient for large or complex scalp defects, especially those with prior radiation therapy.
Purpose of the Study:
- To present surgical cases of complex scalp defects.
- To analyze reconstruction methods, complications, and outcomes.
- To discuss optimal reconstruction strategies for challenging scalp defects.
Main Methods:
- Retrospective analysis of 14 patients with complex scalp defects treated between December 2017 and August 2019.
- Evaluation of patient demographics, defect characteristics, and surgical interventions.
- Detailed assessment of reconstruction techniques, including cranioplasty and free flap choices.
Main Results:
- Free flaps, including latissimus dorsi and anterolateral thigh, were successfully used in all 14 patients without flap loss.
- Cranioplasties utilized rib grafts, bone grafts, and titanium mesh.
- Complications in four patients included partial graft loss, wound dehiscence, seroma, and aesthetic concerns.
Conclusions:
- Free tissue transfer is the preferred method for complex scalp defects over local flaps.
- Appropriate selection of reconstruction techniques, considering patient comorbidities, is vital for successful outcomes.
- This study highlights the efficacy of free flaps in managing challenging scalp reconstructions.
